Close up image of a caretaker helping older woman walk

Should the Republican healthcare bill gain more support and pass after the July 4 recess, providers worried this week over whether, sooner or later, they’d have to cut staff.

It’s unclear what each state and nursing facility would do in the face of a total possible $772 billion in Medicaid reductions, but Mark Parkinson, president and CEO of the American Health Care Association, said Monday it would be devastating news for the sector’s workforce.

“There are two million people who work in nursing facilities. We’re the 10th largest employer in the country. If the bill got into effect, then what would be the breaking point? If the government didn’t step in, would these jobs would be lost?” he said.

In Denver, Holly Heights Nursing Center executive director Janet Snipes told the Washington Post that she’d have to reduce her workforce, which is around 170 employees.

“We can’t take a significant cut and not do staff reduction,” she told the newspaper. “And when staff is reduced, care can be compromised.”

The caveat to the uncertainty is individual states could choose to raise Medicaid reimbursement rates for nursing homes in the face of federal dialback. But most states would face either raising taxes or cutting services, AARP Legislative Policy Director David Certner said Wednesday during a media call.

“These are hard choices that are going to be pushed back on the states,” he said, noting that the entire long-term care sector, including home and community-based service providers, would be hit by the Medicaid reductions proposed. “We don’t know exactly, but when you have 25% cuts, we know that there’s going to be pretty negative impact on services provided.”

President Trump also weighed in on the healthcare bill Wednesday, promising a “great great surprise.”